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P3‐292: LIFE CONCERNS OF ELDERLY PEOPLE LIVING AT HOME DETERMINED BY COMMUNITY GENERAL SUPPORT CENTER STAFF: IMPLICATIONS FOR ORGANIZING A MORE EFFECTIVE INTEGRATED COMMUNITY CARE SYSTEM–THE KURIHARA PROJECT
Author(s) -
Takada Junko,
Meguro Kenichi,
Sato Yuko,
Chiba Yumiko
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.1384
Subject(s) - checklist , intervention (counseling) , psychological intervention , certification , psychology , gerontology , nursing , medicine , political science , law , cognitive psychology
Project Description: In Japan, the integrated community care system aims to enable people to continue to live in their home towns to the end of their lives with a sense of security once they are in severe need of long-term care. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Project. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Project. To compensate the BC by finding people not respond the BC, the staff evaluated the files of 592 subjects participating in the Kurihara project, independent of the checklist application, to identify (1) activities they cannot do that they did in the past, (2) decreased activity levels at home, (3) loss of interaction with people other than their family, and (4) need for medical interventions. This information was classified into categories of (A) "no life concerns", when none of these items were applicable, (B) "undecided", and (C) "life concerns", when any item was applicable. The relationships of these classifications with clinical information, certification of the need for long-term care, and items on the BC were subsequently examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns defined by the staff were related to scores on the CDR, MMSE, and GDS. Medical intervention was most common in AD and exercise was most common in VaD. Most items on the BC were not associated with classification into category C, but 25% of the subjects with these items also had life concerns. Of the patients with AD, 80% were classified into category C, but only 20% applied to Long-Term Care Insurance (LTCI). All VaD were in category C, but only 50% applied to LTCI.Judgment of life concerns by the CGSC staff may have some clinical validity. The results of the study suggest the presence of people who do not respond the checklist or apply the LTCI thus resulting to "hide" in the community, probably due to apathy or depressive state.